What is a Health History Questionnaire?

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  • Written By: wiseGEEK Writer
  • Edited By: O. Wallace
  • Last Modified Date: 21 October 2019
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A health history questionnaire is a document of varying length that may be used in a variety of settings. People often encounter these questionnaires when they visit new doctors or see a specialist. This is by no means the only use of a health history questionnaire. Colleges and athletic programs or athletic companies like health clubs use them too. Life or health insurance companies might also use one to determine eligibility for insurance.

Each health history questionnaire could have a varied format and ask slightly different questions. One thing that could be asked is whether a person is currently or has recently been ill in any way. People might be required to list recent illnesses that caused hospitalization, diagnosis of any serious illnesses, and any surgeries that may have occurred in the last few years. Another common set of questions deals with food and medication allergies and is important to fill out accurately. After answering these questions, people may find a checklist of diseases and conditions they need to mark if they have any of them.

The checklist may actually require two sorts of information. It may have space to mark to identify if the person filling out the health history questionnaire has one of the diseases, and it may also have a space to indicate if a family member has one of the diseases listed. When used by doctors, the latter can be important in determining risk for certain illnesses in the future.


Some of these disease/illness checklists are quite extensive. They often ask about personal/family history regarding illnesses that could include heart disease, mental illness, diabetes, cancer, hormonal imbalances, and problems with bones/muscles. A questionnaire might even ask people to identify family members with these conditions to determine risk to the person filling out the form.

Another aspect of a health history questionnaire is frequently used in colleges. It may ask incoming students to list vaccination history to determine if a student could use some vaccinations. Since many colleges have health centers, this service can then be offered to students, and might protect the whole college population.

Gyms and any type of business that has a sport element to it frequently ask people to fill out these questionnaires so they can inform clients of potential risks of participation. If they see a long list of risk factors for heart disease or other disorders that can contribute to the risk of injury, they may even ask people to see a doctor first, prior to participating. These forms are one way of minimizing insurance risk to the gym because gyms can inform people that they participate at their own risk, and in responsible companies it is also a method for protecting people who might be engaging in activities that are not safe for them.

One challenging aspect of the health history questionnaire is when this information will be filled out and shown to medical insurance companies. With an increasing number of people being declared uninsurable, many people worry that even having a family history of certain diseases places them at risk for losing insurance or having to pay much higher rates. In many cases, when these forms will be shared with insurance companies, people may be able to opt out of filling out the form, or they might request the form not be shown, and it is the patient’s right in most regions to find out who gets to see the form. These options do not exist when people fill out questionnaires for life insurance companies or if they are completing them for a health insurance company to which they are applying for insurance.



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